DWC Revises Forms
Saturday, September 13, 2014 09:12 AM

The Division of Workers’ Compensation (DWC) has finalized revisions to DWC Form-026, Request for Reimbursement of Payment Made by Health Care Insurer and DWC Form-069, Report of Medical Evaluation.

The revisions replace the term “ICD-9” with the term “diagnosis code.”

The purpose of the revisions is to facilitate the transition from ICD-9 coding to ICD-10 coding for workers’ compensation medical billing, processing and reporting purposes in order to maintain consistency with federal regulations.  ICD-9 and ICD-10 refer to the 9th edition and the 10th edition, respectively, of the International Classification of Diseases, Clinical Modification and Procedure Coding System.

Additionally, DWC added instructions for injured employees on DWC Form-069, Report of Medical Evaluation.

The finalized forms are available on the Texas Department of Insurance website at http://www.tdi.texas.gov/forms/form20numeric.html.

The finalized forms are effective January 1, 2015.